The prevalence of porcine gastric ulcer and Helicobacter suis in Taiwan.

Gastric ulcer is a common disease affecting pigs worldwide, with a prevalence reported as high as 93%. The cause of porcine gastric ulcer is multifactorial, with Helicobacter suis (H. suis) being considered as the primary pathogenic factor. To date, prevalence of H. suis resulting in porcine gastric ulcer in Taiwan has not been investigated. In this study, we collected 360 pig stomachs from the slaughterhouses. In addition, stomach tissues from the 88 diseased pigs submitted for necropsy were divided into symptomatic and asymptomatic groups. Gastric lesions were scored, and polymerase chain reaction was used to determine the occurrence of gastric ulcer and the prevalence of H. suis. The positive rate of H. suis in the samples from slaughtered pigs was 49.7%, and both infection of H. suis and the presence of gastric lesions were prone to occur in autumn. The positive rates of H. suis infection in the symptomatic and asymptomatic groups were 59.1% and 31.8%, respectively. Moreover, the proportion of the samples with gastroesophageal ulcer in the symptomatic group was 68.2%, predominantly observed in growing pigs. The incidence of the samples from the slaughterhouses with gastroesophageal erosion to ulceration revealed a significant difference between H. suis -infected and H. suis -uninfected pigs; however, there is no significant difference in the samples of diseased pigs. In conclusion, H. suis infection was associated with gastric ulcer in slaughtered pigs, but it was not the primary cause of gastroesophageal ulcer in diseased pigs with clinical symptoms.

Differential leaf flooding resilience in Arabidopsis thaliana is controlled by ethylene signaling-activated and age-dependent phosphorylation of ORESARA1.

The phytohormone ethylene is a major regulator of plant adaptive responses to flooding. In flooded plant tissues, ethylene quickly increases to high concentrations owing to its low solubility and diffusion rates in water. Ethylene accumulation in submerged plant tissues makes it a reliable cue for triggering flood acclimation responses, including metabolic adjustments to cope with flood-induced hypoxia. However, persistent ethylene accumulation also accelerates leaf senescence. Stress-induced senescence hampers photosynthetic capacity and stress recovery. In submerged Arabidopsis, senescence follows a strict age-dependent pattern starting with the older leaves. Although mechanisms underlying ethylene-mediated senescence have been uncovered, it is unclear how submerged plants avoid indiscriminate breakdown of leaves despite high systemic ethylene accumulation. We demonstrate that although submergence triggers leaf-age-independent activation of ethylene signaling via EIN3 in Arabidopsis, senescence is initiated only in old leaves. EIN3 stabilization also leads to overall transcript and protein accumulation of the senescence-promoting transcription factor ORESARA1 (ORE1) in both old and young leaves during submergence. However, leaf-age-dependent senescence can be explained by ORE1 protein activation via phosphorylation specifically in old leaves, independent of the previously identified age-dependent control of ORE1 via miR164. A systematic analysis of the roles of the major flooding stress cues and signaling pathways shows that only the combination of ethylene and darkness is sufficient to mimic submergence-induced senescence involving ORE1 accumulation and phosphorylation. Hypoxia, most often associated with flooding stress in plants, appears to have no role in these processes. Our results reveal a mechanism by which plants regulate the speed and pattern of senescence during environmental stresses such as flooding. Age-dependent ORE1 activity ensures that older, expendable leaves are dismantled first, thus prolonging the life of younger leaves and meristematic tissues that are vital to whole-plant survival.

Enhancement-Mode Ambipolar Thin-Film Transistors and CMOS Logic Circuits using Bilayer Ga2O3/NiO Semiconductors.

Recent advancements in power electronics have been driven by Ga2O3-based ultrawide bandgap (UWBG) semiconductor devices, enabling efficient high-current switching. However, integrating Ga2O3 power devices with essential silicon CMOS logic circuits for advanced control poses fabrication challenges. Researchers have introduced Ga2O3-based NMOS and pseudo-CMOS circuits for integration, but these circuits may either consume more power or increase the design complexity. Hence, this article proposes Ga2O3-based CMOS realized using heterogeneous 3D-stacked bilayer ambipolar transistors. These ambipolar transistors consist of HfO2/NiO/Ga2O3/NiO/HfO2 heterostructures that are wrapped around by the Ti/Au gate electrode, resulting in record high electron and hole current on/off ratios of 109 and 107. The threshold voltage, subthreshold swing, and current density measured from 100 ambipolar devices (across 5 batches) are around -7.99 ± 0.92 V (p-channel) and 7.81 ± 0.81 V (n-channel), 0.59 ± 0.07 V/dec (p-channel) and 0.61 ± 0.06 V/dec (n-channel), and 0.99 ± 0.26 mA/mm (p-channel) and 58.23 ± 12.99 mA/mm (n-channel), respectively. All the 100 ambipolar devices showed decent long-term stability over a period of 200 days, exhibiting reliable electrical performance. The threshold voltage shift (ΔVTH) after negative bias stressing for a period of 3500 s is around 11.52 V (p-channel) and 10.21 V (n-channel), respectively. Notably, the n-channels exhibit ∼2 orders higher on/off ratio than the best Ga2O3 unipolar transistors at 300 °C. Moreover, the polarities of ambipolar transistors are reconfigurable into p- or n-MOS, which are integrated to demonstrate CMOS inverter, NOR, and NAND logic gates. The switching periods from "0" to "1" and from "1" to "0" of NOR are 0.12 and 0.17 µs, and those of NAND are 0.16 and 0.13 µs. This work lays the foundation of oxide-semiconductor-based CMOS for future integrated electronics.

Trapdoor Deformity Correction Post Nasal Bilobed Flaps for Basal Cell Carcinoma Reconstruction With Multiple Laser Modalities.

ABSTRACT: In case of excision of nasal basal cell carcinoma (BCC), bilobed flaps are considered the criterion standard of reconstruction for defect less than 15 mm in size. However, there is still a risk of trapdoor deformity formation, of which its treatment is less discussed. A 44-year-old woman who was diagnosed with nasal BCC and underwent tumor excision with bilobed flap reconstruction presented with trapdoor deformity postoperatively. The computed Vancouver Scar Scale was 7. After early intervention of multiple laser modalities, including 2 sessions of 585-nm pulsed dye laser with a fluence of 9 J/cm2, pulse duration of 6 milliseconds, and spot size of 6 mm, 2940-nm Er-yttrium aluminum garnet (YAG) laser with a pulse energy of 800-900 mJ, repetition rate of 8-9 Hz, and laser spot size of 3-7 mm, and 5 sessions of 1064-nm Nd:YAG fractional picosecond laser with a pulse energy of 2.30-2.70 mJ, repetition rate of 8 Hz, and laser spot size of 6 mm from 5 to 23 weeks postoperatively, the Vancouver Scar Scale score improved to 1, with significant reduction of trapdoor scar erythema and puffiness. Although BCC is often curable, tumor excision causes unsatisfactory appearance satisfaction problem, owing to the apparent location of the lesion. Factors, such as sebaceous tissue thickness, reconstruction over multiple aesthetic subunits of nose, and damage to nasal cartilage framework structure during tumor removal, may increase the risk of trapdoor formation. Early intervention with multiple laser treatment can significantly revise the deformity.

Aldosteronism is associated with more severe cerebral small vessel disease in hypertensive intracerebral hemorrhage.

Primary aldosteronism is associated with various types of cardiovascular and cerebrovascular damage independently of hypertension. Although chronic hypertension and related cerebral arteriosclerosis are the main risk factors for intracerebral hemorrhage, the effects of aldosteronism remain poorly understood. We enrolled 90 survivors of hypertensive intracerebral hemorrhage, 21 of them with aldosteronism and 69 with essential hypertension as controls in this study. Clinical parameters and neuroimaging markers of cerebral small vessel disease were recorded, and its correlations with aldosteronism were investigated. Our results showed that the aldosteronism group (55.2 ± 9.7 years, male 47.6%) had similar hypertension severity but exhibited a higher cerebral microbleed count (interquartile range) (8.5 [2.0‒25.8] vs 3 [1.0‒6.0], P = 0.005) and higher severity of dilated perivascular space in the basal ganglia (severe perivascular space [number >20], 52.4% vs. 24.6%, P = 0.029; large perivascular space [>3 mm], 52.4% vs. 20.3%, P = 0.010), compared to those with essential hypertension (53.8 ± 11.7 years, male 73.9%). In multivariate models, aldosteronism remained an independent predictor of a higher (>10) microbleed count (odds ratio = 8.60, P = 0.004), severe perivascular space (odds ratio = 4.00, P = 0.038); the aldosterone-to-renin ratio was associated with dilated perivascular space (P = 0.043) and large perivascular space (P = 0.008). In conclusions, survivors of intracerebral hemorrhage with aldosteronism showed a tendency towards more severe hypertensive arteriopathy than the essential hypertension counterparts independently of blood pressure; aldosteronism may contribute to dilated perivascular space around the deep perforating arteries. Aldosteronism is associated with more severe cerebral small vessel disease in hypertensive intracerebral hemorrhage.

Reversal of arterial stiffness in medically and surgically treated unilateral primary aldosteronism.

OBJECTIVE: Hyperaldosteronism has adverse effects on cardiovascular structure and function. Laparoscopic adrenalectomy is the gold standard for patients with unilateral primary aldosteronism. For unilateral primary aldosteronism patients unable or unwilling to undergo surgery, the effects of mineralocorticoid receptor antagonists (MRAs) on the reversibility of arterial stiffness and other clinical data remain unclear. We aimed to compare the reversibility of arterial stiffness using pulse wave velocity (PWV) and other clinical parameters between surgically and medically treated unilateral primary aldosteronism patients. METHODS: We prospectively enrolled 306 unilateral primary aldosteronism patients, of whom 247 received adrenalectomy and 59 received medical treatment with MRAs. Detailed medical history, basic biochemistry and PWV data were collected in both groups before treatment and 1 year after treatment. After propensity score matching (PSM) for age, sex, SBP and DBPs, 149 patients receiving adrenalectomy and 54 patients receiving MRAs were included for further analysis. RESULTS: After PSM, the patients receiving adrenalectomy had a greater reduction in blood pressure, increase in serum potassium, and change in PWV (ΔPWV, -53 ±â€Š113 vs. -10 ±â€Š140 cm/s, P  = 0.028) than those receiving MRAs 1 year after treatment. Multivariable regression analysis further identified that surgery (compared with MRA treatment), baseline PWV, baseline DBP, the change in DBP and the use of diuretics were independently correlated with ΔPWV. CONCLUSION: Adrenalectomy is superior to MRA treatment with regards to vascular remodeling when treating unilateral primary aldosteronism patients.

Plasma-Promoted Ammonia Decomposition over Supported Ruthenium Catalysts for COx -Free H2 Production.

The efficient decomposition of ammonia to produce COx -free hydrogen at low temperatures has been extensively investigated as a potential method for supplying hydrogen to mobile devices based on fuel cells. In this study, we employed dielectric barrier discharge (DBD) plasma, a non-thermal plasma, to enhance the catalytic ammonia decomposition over supported Ru catalysts (Ru/Y2 O3 , Ru/La2 O3 , Ru/CeO2 and Ru/SiO2 ). The plasma-catalytic reactivity of Ru/La2 O3 was found to be superior to that of the other three catalysts. It was observed that both the physicochemical properties of the catalyst (such as support acidity) and the plasma discharge behaviours exerted significant influence on plasma-catalytic reactivity. Combining plasma with a Ru catalyst significantly enhanced ammonia conversion at low temperatures, achieving near complete NH3 conversion over the 1.5 %-Ru/La2 O3 catalyst at temperatures as low as 380 °C. Under a weight gas hourly space velocity of 2400 mL gcat -1 h-1 and an AC supply power of 20 W, the H2 formation rate and energy efficiency achieved were 10.7 mol gRu -1 h-1 and 535 mol gRu -1 (kWh)-1 , respectively, using a 1.5 %-Ru/La2 O3 catalyst.

Cardiovascular and metabolic characters of KCNJ5 somatic mutations in primary aldosteronism.

Background: Primary aldosteronism (PA) is the leading cause of curable endocrine hypertension, which is associated with a higher risk of cardiovascular and metabolic insults compared to essential hypertension. Aldosterone-producing adenoma (APA) is a major cause of PA, which can be treated with adrenalectomy. Somatic mutations are the main pathogenesis of aldosterone overproduction in APA, of which KCNJ5 somatic mutations are most common, especially in Asian countries. This article aimed to review the literature on the impacts of KCNJ5 somatic mutations on systemic organ damage. Evidence acquisition: PubMed literature research using keywords combination, including "aldosterone-producing adenoma," "somatic mutations," "KCNJ5," "organ damage," "cardiovascular," "diastolic function," "metabolic syndrome," "autonomous cortisol secretion," etc. Results: APA patients with KCNJ5 somatic mutations are generally younger, female, have higher aldosterone levels, lower potassium levels, larger tumor size, and higher hypertension cure rate after adrenalectomy. This review focuses on the cardiovascular and metabolic aspects of KCNJ5 somatic mutations in APA patients, including left ventricular remodeling and diastolic function, abdominal aortic thickness and calcification, arterial stiffness, metabolic syndrome, abdominal adipose tissue, and correlation with autonomous cortisol secretion. Furthermore, we discuss modalities to differentiate the types of mutations before surgery. Conclusion: KCNJ5 somatic mutations in patients with APA had higher left ventricular mass (LVM), more impaired diastolic function, thicker aortic wall, lower incidence of metabolic syndrome, and possibly a lower incidence of concurrent autonomous cortisol secretion, but better improvement in LVM, diastolic function, arterial stiffness, and aortic wall thickness after adrenalectomy compared to patients without KCNJ5 mutations.

Anatomical and functional remodeling of left ventricle in patients with primary aldosteronism and concomitant albuminuria.

Background: Primary aldosteronism (PA) is the leading cause of secondary hypertension globally and is associated with adverse cardiovascular outcomes. However, the cardiac impact of concomitant albuminuria remains unknown. Objective: To compare anatomical and functional remodeling of left ventricle (LV) in PA patients with or without albuminuria. Design: Prospective cohort study. Methods: The cohort was separated into two arms according to the presence or absence of albuminuria (>30 mg/g of morning spot urine). Propensity score matching with age, sex, systolic blood pressure, and diabetes mellitus was performed. Multivariate analysis was conducted with adjustments for age, sex, body mass index, systolic blood pressure, duration of hypertension, smoking, diabetes mellitus, number of antihypertensive agents, and aldosterone level. A local-linear model with bandwidth of 2.07 was used to study correlations. Results: A total of 519 individuals with PA were enrolled in the study, of whom 152 had albuminuria. After matching, the albuminuria group had a higher creatinine level, at baseline. With regard to LV remodeling, albuminuria was independently associated with a significantly higher interventricular septum (1.22 > 1.17 cm, p = 0.030), LV posterior wall thickness (1.16 > 1.10 cm, p = 0.011), LV mass index (125 > 116 g/m2, p = 0.023), and medial E/e' ratio (13.61 > 12.30, p = 0.032), and a lower medial early diastolic peak velocity (5.70 < 6.36 cm/s, p = 0.016). Multivariate analysis further revealed that albuminuria was an independent risk factor for elevated LV mass index (p < 0.001) and medial E/e' ratio (p = 0.010). Non-parametric kernel regression also demonstrated that the level of albuminuria was positively correlated with LV mass index. The remodeling of LV mass and diastolic function under the presence of albuminuria distinctly improved after PA treatment. Conclusion: The presence of concomitant albuminuria in patients with PA was associated with pronounced LV hypertrophy and compromised LV diastolic function. These alterations were reversible after treatment for PA. Plain language summary: Cardiac Impact of Primary Aldosteronism and Albuminuria Primary aldosteronism and albuminuria has been, respectively, demonstrated to bring about left ventricular remodeling, but the aggregative effect was unknown. We constructed a prospective single-center cohort study in Taiwan. We proposed the presence of concomitant albuminuria was associated with left ventricular hypertrophy and compromised diastolic function. Intriguingly, management of primary aldosteronism was able to restore these alterations. Our study delineated the cardiorenal crosstalk in the setting of secondary hypertension and the role of albuminuria for left ventricular remodeling. Future interrogations toward the underlying pathophysiology as well as therapeutics will facilitate the improvement of holistic care for such population.

Mineralocorticoid receptor antagonist treatment improved arterial stiffness in patients with primary aldosteronism: a cohort study compared with adrenalectomy.

Background: Elevated arterial stiffness in patients with primary aldosteronism (PA) can be reversed after adrenalectomy; however, the effect of medical treatment with mineralocorticoid receptor antagonist (MRAs) is unknown. Objectives: The aim of this study was to evaluate the effect of MRAs and compare both treatment strategies on arterial stiffness in PA patients. Design: Prospective cohort study. Methods: We prospectively enrolled PA patients from 2006 to 2019 who received either adrenalectomy or MRA treatment (spironolactone). We compared their baseline and 1-year post-treatment biochemistry characteristics and arterial pulse wave velocity (PWV) to verify the effects of treatment and related determinant factors. Results: A total 459 PA patients were enrolled. After 1:1 propensity score matching for age, sex and blood pressure (BP), each group had 176 patients. The major determinant factors of baseline PWV were age and baseline BP. The adrenalectomy group had greater improvements in BP, serum potassium level, plasma aldosterone concentration, and aldosterone-to-renin ratio. The MRA group had a significant improvement in PWV after 1 year of treatment (1706.2 ± 340.05 to 1613.6 ± 349.51 cm/s, p < 0.001). There were no significant differences in post-treatment PWV (p = 0.173) and improvement in PWV (p = 0.579) between the adrenalectomy and MRA groups. The determinant factors for an improvement in PWV after treatment were hypertension duration, baseline PWV, and the decrease in BP. Conclusion: The PA patients who received medical treatment with MRAs had a significant improvement in arterial stiffness. There was no significant difference in the improvement in arterial stiffness between the two treatment strategies.

Diabetes mellitus is associated with more adverse non-hemodynamic left ventricular remodeling and less recovery in patients with primary aldosteronism.

The elevated aldosterone in primary aldosteronism (PA) is associated with increased insulin resistance and prevalence of diabetes mellitus (DM). Both aldosterone excess and DM lead to left ventricular (LV) pathological remodeling. In this study, we investigated the impact of DM on LV non-hemodynamic remodeling in patients with PA. We enrolled 665 PA patients, of whom 112 had DM and 553 did not. Clinical, biochemical, and echocardiographic data were analyzed at baseline and 1 year after adrenalectomy. LV non-hemodynamic remodeling was represented by inappropriate excess left ventricular mass index (ieLVMI), which was defined as the difference between left ventricular mass index (LVMI) and predicted left ventricular mass index (pLVMI). Propensity score matching (PSM) was used with age, sex, systolic, and diastolic blood pressure to adjust for baseline variables. After PSM, the patient characteristics were balanced between the DM and non-DM groups, except for fasting glucose, HbA1c, and lipid profile. A total of 111 DM and 419 non-DM patients were selected for further analysis. Compared to the non-DM group, the DM group had significantly higher ieLVMI and LVMI. After multivariable linear regression analysis, the presence of DM remained a significant predictor of increased ieLVMI. After adrenalectomy, ieLVMI decreased significantly in the non-DM group but not in DM group. The presence of DM in PA patients was associated with more prominent non-hemodynamic LV remodeling and less recovery after adrenalectomy.

Local light signaling at the leaf tip drives remote differential petiole growth through auxin-gibberellin dynamics.

Although plants are immobile, many of their organs are flexible to move in response to environmental cues. In dense vegetation, plants detect neighbors through far-red light perception with their leaf tip. They respond remotely, with asymmetrical growth between the abaxial and adaxial sides of the leafstalk, the petiole. This results in upward movement that brings the leaf blades into better lit zones of the canopy. The plant hormone auxin is required for this response, but it is not understood how non-differential leaf tip-derived auxin can remotely regulate movement. Here, we show that remote signaling of far-red light promotes auxin accumulation in the abaxial petiole. This local auxin accumulation is facilitated by reinforcing an intrinsic directionality of the auxin transport protein PIN3 on the petiole endodermis, as visualized with a PIN3-GFP line. Using an auxin biosensor, we show that auxin accumulates in all cell layers from endodermis to epidermis in the abaxial petiole, upon far-red light signaling in the remote leaf tip. In the petiole, auxin elicits a response to both auxin itself as well as a second growth promoter; gibberellin. We show that this dual regulation is necessary for hyponastic leaf movement in response to light. Our data indicate that gibberellin is required to permit cell growth, whereas differential auxin accumulation determines which cells can grow. Our results reveal how plants can spatially relay information about neighbor proximity from their sensory leaf tips to the petiole base, thus driving adaptive growth.

Implication of MR Activity in Posttreatment Arterial Stiffness Reversal in Patients With Primary Aldosteronism.

CONTEXT: Primary aldosteronism (PA) patients have a higher degree of arterial stiffness, which can be reversed after adrenalectomy. OBJECTIVE: We aimed to compare the reversal of arterial stiffness between surgically and medically treated PA patients and to identify the predictors of effective medical treatment. METHODS: We prospectively enrolled 445 PA patients and collected data on baseline clinical characteristics, biochemistry, blood pressure, and pulse wave velocity (PWV) before treatment and 12 months after treatment. In the mineralocorticoid receptor antagonist (MRA)-treated patients, the relationship between the change in PWV after 1 year (ΔPWV) and posttreatment renin activity was explored using the restricted cubic spline (RCS) method. RESULTS: Of the 445 enrolled PA patients, 255 received adrenalectomy (group 1) and 190 received MRAs. In the RCS model, posttreatment plasma renin activity (PRA) 1.5 ng/mL/h was the best cutoff value. Therefore, we divided the MRA-treated patients into 2 groups: those with suppressed PRA (< 1.5 ng/mL/h, group 2), and those with unsuppressed PRA (≥ 1.5 ng/mL/h, group 3). Only group 1 and group 3 patients had a statistically significant improvement in PWV after treatment (both P < .001), whereas no significant improvement was noted in group 2 after treatment (P = .151). In analysis of variance and post hoc analysis, group 2 had a significantly lower ΔPWV than group 1 (P = .007) and group 3 (P = .031). Multivariable regression analysis of the MRA-treated PA patients identified log-transformed posttreatment PRA, age, and baseline PWV as independent factors correlated with ΔPWV. CONCLUSION: The reversal of arterial stiffness was found in PA patients receiving adrenalectomy and in medically treated PA patients with unsuppressed PRA.

Synergistic effect of albuminuria on atherosclerosis in patients with primary aldosteronism.

Background: Primary aldosteronism (PA) has been associated with atherosclerosis beyond the extent of essential hypertension, but the impact of albuminuria remains unknown. Objective: To investigate the effect of concomitant albuminuria on arterial stiffness in PA. Design: Prospective cohort study. Methods: A prospective cohort study was conducted to evaluate the association of albuminuria (>30 mg/g in morning spot urine) with arterial stiffness, as measured non-invasively by pulse wave velocity (PWV) in patients with PA. Propensity score matching (PSM) with age, sex, diabetes, systolic and diastolic blood pressure, creatinine, potassium, number of antihypertensive medications, and hypertension history was used to balance baseline characteristics. The effects of albuminuria on PWV before and 1 year after treatment were analyzed. Results: A total of 840 patients with PA were enrolled, of whom 243 had concomitant albuminuria. After PSM, there were no significant differences in baseline demographic parameters except alpha-blocker and spironolactone use. PWV was greater in the presence of albuminuria (p = 0.012) and positively correlated with urine albumin-creatinine ratio. Multivariable regression analysis identified albuminuria, age, body weight, systolic blood pressure, and calcium channel blocker use as independent predictors of PWV. As for treatment response, only PA patients with albuminuria showed significant improvements in PWV after PSM (p = 0.001). The magnitude of improvement in PWV increased with urine albumin-creatinine ratio and reached plateau when it exceeded 100 mg/g according to restricted cubic spline analysis. Conclusion: Concomitant albuminuria in PA was associated with greater arterial stiffness and more substantial improvement after targeted treatment. Both the baseline and the improved extent of PWV increased in correlation with rising urine albumin-creatinine ratio levels, reaching a plateau when the urine albumin-creatinine ratio surpassed 100 mg/g.

Albuminuria and primary aldosteronism synergistically induce atherosclerosis Albuminuria is a common comorbidity in patients with primary aldosteronism (PA), and both has been established to potentiate atherosclerosis. However, the interaction in between remained enigmatic. In this study, we accessed the synergistic vascular impact in a prospectively enrolled cohort. Arterial rigidity was assessed non-invasively by brachial­ankle pulse wave velocity. Concomitant albuminuria in patients with PA was associated with pronouncedly greater arterial stiffness and was further demonstrated as an independent predictor for atherosclerosis. In addition, PA-targeted treatment effectively reversed arterial stiffness, especially in individuals with concomitant albuminuria. The beneficial effect of PA-targeted treatment on PWV increased with rising urine albumin­creatinine ratio levels, eventually plateauing when the UACR surpassed 100 mg/g.

Association between maternal shift work during pregnancy child overweight and metabolic outcomes in early childhood.

Background: Previous studies found that maternal shift work during pregnancy was associated with many reproductive hazards, including small for gestational age, preterm birth, stillbirth, and neurodevelopmental impairment. Some studies also showed that these children are more likely to become overweight in early childhood. However, the association with metabolic factors, such as insulin resistance and dyslipidemia, was less studied. Hence, we aimed to understand better the relationship between maternal shift work during pregnancy and the risk of childhood overweight and metabolic outcomes. Confounding factors were also discussed, including diet, exercise, and demographical factors. Methods: We enrolled pregnant women before delivery in the Taiwan Birth Panel Study (TBPS) II conducted between 2010 and 2012, and followed the children of these participants in 2018. The objective of this study is to investigate the influence of prenatal and postnatal factors on infant and early childhood health. During the follow-up in 2018, we checked children's demographic data, obtained blood specimens, and checked their blood sugar, blood insulin, and lipid profiles. Structured questionnaires were used to evaluate demographic data. Multiple linear and logistic regressions were used to examine the associations between maternal shift work during pregnancy and child overweight, metabolic disorders, such as HOMA-IR, and lipid profiles. Results: In this study, we included 407 mother-children pairs with different work shifts (350 day workers and 57 shift workers), and a sub-population without underweight children was also created (290 day workers and 47 shift workers). Shift work during pregnancy was associated with a higher Homeostasis Model Assessment-Insulin Resistance index (HOMA-IR) and a higher odds ratio for overweight in children born from mothers doing shift work during pregnancy after adjustment. The findings were attenuated when we investigated the effect of shift work before pregnancy. Conclusion: Our study suggested that maternal shift work during pregnancy was associated with child overweight and insulin resistance in early childhood.

Transferable Ga2O3 Membrane for Vertical and Flexible Electronics via One-Step Exfoliation.

Transferable Ga2O3 thin film membrane is desirable for vertical and flexible solar-blind photonics and high-power electronics applications. However, Ga2O3 epitaxially grown on rigid substrates such as sapphire, Si, and SiC hinders its exfoliation due to the strong covalent bond between Ga2O3 and substrates, determining its lateral device configuration and also hardly reaching the ever-increasing demand for wearable and foldable applications. Mica substrate, which has an atomic-level flat surface and high-temperature tolerance, could be a good candidate for the van der Waals (vdW) epitaxy of crystalline Ga2O3 membrane. Beyond that, benefiting from the weak vdW bond between Ga2O3 and mica substrate, in this work, the Ga2O3 membrane is exfoliated and transferred to arbitrary flexible and adhesive tape, allowing for the vertical and flexible electronic configuration. This straightforward exfoliation method is verified to be consistent and reproducible by the transfer and characterization of thick (∼380 nm)/thin (∼95 nm) κ-phase Ga2O3 and conductive n-type ß-Ga2O3. Vertical photodetectors are fabricated based on the exfoliated Ga2O3 membrane, denoting the peak response at ∼250 nm. Through the integration of Ti/Au Ohmic contact and Ni/Ag Schottky contact electrode, the vertical photodetector exhibits self-powered photodetection behavior with a responsivity of 17 mA/W under zero bias. The vdW-bond-assisted exfoliation of the Ga2O3 membrane demonstrated here could provide enormous opportunities in the pursuit of vertical and flexible Ga2O3 electronics.

Reflective metalens with an enhanced off-axis focusing performance.

Metalenses are one of the most promising metasurface applications. However, all-dielectric reflective metalenses are rarely studied, especially regarding their off-axis focusing performance. After experimentally studying the material optical properties in this work, we propose reflective metalens based on titanium dioxide (TiO2) and silicon dioxide (SiO2), which operate at a visible wavelength of 0.633 µm. Unlike conventional reflective metalenses based on metallic mirrors, the proposed device was designed based on a modified parabolic phase profile and was integrated onto a dielectric distributed Bragg reflector periodic structure to achieve high reflectivity with five dielectric pairs. The focusing efficiency characteristics of the metalens were experimentally studied for beam angles of incidence between 0∘ and 30∘. The results reveal that the focusing efficiency for the modified metalens design remains higher than 54%, which is higher than 50%, making it promising for photonic miniaturization and integration.

Quality of Life Among Geriatric Community Members Following the Kaohsiung Gas Explosion: A 5-Year Cross-Sectional Study.

OBJECTIVE: The aim was to conduct a follow-up study of the quality of life (QoL) and to measure lifestyle factors among the aging survivors of a petrochemical gas explosion in Taiwan 5 years after the event. METHODS: A community-based survey with cross-sectional assessments was conducted with residents of a community who experienced a petrochemical gas explosion 5 years after the disaster. Short Form 12v2 (SF-12v2) was used to survey a representative sample of participants. RESULTS: The risk factors for different QoL subscales were stressors and chronic physical illness, and the protective factors were higher income and better diet and exercise habits. The elderly participants had better diet and exercise habits than the younger participants in this survey. Aging had a negative impact on the physical QoL subscales [physical functioning (PF), bodily pain (BP), general health (GH), Physical Component Summary (PCS)] but a positive impact on psychological QoL subscales [vitality (VT), social functioning (SF), emotional problems (RE), mental health (MH), Mental Health Component Summary (MCS)]. CONCLUSIONS: While participants' psychiatric status had improved after 5 years, their QoL continued to be affected, especially in those with stress and physical illness. The elderly groups maintained a relatively acceptable QoL in terms of psychological aspects. Postdisaster treatment and follow-up should be addressed to a greater degree, especially in victims with mental illness or chronic illness and those with fewer socioeconomic resources.

Concurrent aspergillosis and cystic pulmonary metastases in a patient with tongue squamous cell carcinoma.

Pulmonary Aspergillus infection may have a variety of manifestations depending on the patients' immunity status and pre-existing lung conditions. Radiographically, aspergilloma, which is usually associated with noninvasive Aspergillus fumigatus conidia, may feature a characteristic mass in a cavity commonly located in the upper lobes of the lung. It is typically encountered upon pre-existing lung damage. Here we report Aspergillus growing in a pulmonary metastatic cavity in a 47-year-old male worker with a history of tongue cancer after a radical operation with neck dissection and concurrent chemotherapy in 2014. Chest radiography and computed tomography showed a cavitary lesion with a ball-in-hole lesion in the right upper lobe (RUL) and two cystic lesions within the bilateral upper lung field. Endobronchial ultrasound-guided transbronchial biopsy (EBUS-TBB) from the RUL anterior segmental bronchus (RB3) revealed the presence of Aspergillus conidia and squamous cell carcinoma. Wedge resection of the cystic lesion within the left upper lobe confirmed the diagnosis of metastatic squamous cell carcinoma. This is a rare case of aspergillosis within cavities of pulmonary metastases in a patient who was diagnosed with tongue squamous cell carcinoma. The conclusive distinction between neoplasm and fungal infection is difficult to achieve by radiography, and a pathological biopsy by EBUS-TBB is necessary to aid diagnosis. Clinicians should be aware of such an atypical presentation of metastases coexisting with Aspergillus infection.

Ultrasensitive Flexible κ-Phase Ga2O3 Solar-Blind Photodetector.

Flexible Ga2O3 photodetectors have attracted considerable interest owing to their potential use in the development of implantable, foldable, and wearable optoelectronics. In particular, ß-phase Ga2O3 has been most widely investigated due to the highest thermodynamic stability. However, high-quality ß-phase Ga2O3 relies on the ultrahigh crystallization temperature (usually ≥750 °C), beyond the thermal tolerance of most flexible substrates. In this work, we epitaxially grow a high-quality metastable κ-phase Ga2O3 (002) thin film on a flexible mica (001) substrate under 680 °C and develop a flexible κ-Ga2O3 thin film photodetector with ultrahigh performance. Epitaxial κ-Ga2O3 and the mica substrate are maintained to be thermally stable up to 750 °C, suggesting their potential for harsh environment applications. The responsivity, on/off ratio, detectivity, and external quantum efficiency of the fabricated photodetector are 703 A/W, 1.66 × 107, 4.08 × 1014 Jones, and 3.49 × 105 %, respectively, for 250 nm incident light and a 20 V bias voltage. These values are record-high values reported to date for flexible Ga2O3 photodetectors. Furthermore, the flexible photodetector shows robust flexibility for bending radii of 1, 2, and 3 cm. More importantly, it shows strong mechanical stability against 10,000 bending test cycles. These results reveal the significance of high-quality κ-phase Ga2O3 grown heteroepitaxially on a flexible mica substrate, especially its potential for use in future flexible solar-blind detection systems.